Two-thirds of the 30 million Americans who will be eligible for individual coverage next year are uninsured today, whether because they can’t afford it now or because they’re barred by pre-existing condition limitations, which will no longer be legal. The difference is that Americans learning that they’ll be eligible for coverage perhaps for the first time, or at sharply lower cost, are far more typical of the individual insurance market. They’re anecdotes, sure, just like the anecdotes you’ve been seeing and reading about people learning they’ll be paying more for coverage next year. We’ve compiled several alternative examples for this post. These are the stories you’re not hearing amid the pumped-up panic over canceled individual policies and premium shocks-many of which stories are certainly true, but the noise being made about them leads people to think they’re more common than they are.
But their possible savings will be impressive. They’ll have a higher deductible than Kaiser’s but lower co-pays. Through Covered California, the state’s individual insurance marketplace, they’ve found a plan through Sharp Healthcare that will cover them both for a total premium of $142 a month, after a government subsidy based on their income. “They said, ‘We will not insure you because you have a pre-existing condition,’” Holzman recalls.īut they were lucky, thanks to Obamacare. But the possibility was enough to scare Anthem. She wasn’t sure-her condition was still being diagnosed by Kaiser when her coverage ended. When they applied for a replacement policy with Anthem Blue Cross of California, Ellen, 59, disclosed that she might have carpal tunnel syndrome. That’s when they discovered the chilly hazards of dependence on the individual health insurance market. They’d been living outside Kaiser’s service area, and the health plan had decided to tighten its rules.
The cause wasn’t the Affordable Care Act, as far as they knew. It certainly saved ours.Last summer Ellen Holzman and Meredith Vezina, a married gay couple in San Diego County, got kicked off their long-term Kaiser health plan, for which they’d been paying more than $1,300 a month. We do not consider ourselves disabled at this point in our lives, and in order to remain healthy members of the workforce, we need access to thorough healthcare coverage at affordable rates. He eventually would have to stop working, get on disability, and his only access to healthcare would be visits to the ER until he dies. If the Affordable Care Act is repealed, he would no longer have access to the care and treatment he needs to survive.
Without health insurance, he would not have access to the rheumatologist he needs to see to order his labs and prescribe his medications – medications he needs to live. Now, my boyfriend who has a dual diagnosis of rheumatoid arthritis and psoriasis, is covered through the ACA Marketplace. Without access to these things I would die. Working in the nonprofit sector, I cannot afford to see a rheumatologist and pay for my medications out of pocket. I contribute to society and pay my taxes.
I work full time as a birth parent counselor for an adoption agency.
Although I have since paid these bills off in full, they negatively affected my credit for a few years while I realized they would not be covered and figured out how to slowly pay them off at $50 a month. I incurred $1,200 in medical bills that the insurance company refused to pay because the care was related to my preexisting condition. Naïve to this, I saw my specialist immediately after receiving coverage. Later, after finding a new job, I learned that my preexisting condition would not be covered for the first 10 months. I called all the major health insurance providers but was told over and over again that they could not insure me due to my preexisting condition. I was diagnosed with lupus when I was 16 years old. After college, I began working for a nonprofit that did not offer health insurance.